Innovative reflecting interview: effect on high-utilizing patients with medically unexplained symptoms

Area of Science:

• Primary Care Medicine
• Health Services Research
• Psychosomatic Medicine

Background:

• High-utilizing patients with medically unexplained physical symptoms (MUPS) present a significant challenge in primary care.
• These patients often experience high healthcare utilization and costs, impacting both the healthcare system and individual well-being.

Purpose of the Study:

• To evaluate the impact of a novel reflecting interview on healthcare utilization, physical health, mental function, and satisfaction in high-utilizing primary care patients with MUPS.
• To determine if this intervention can reduce healthcare costs without compromising patient outcomes or satisfaction.

Main Methods:

• A pilot study involving 24 high-utilizing patients with MUPS.
• Random assignment to either a control group (no intervention) or an intervention group receiving a reflecting interview.
• Outcomes including healthcare utilization, physical health, mental function, and satisfaction were assessed at 4 weeks, 6 months, and 1 year.

Main Results:

• The reflecting interview group demonstrated reduced total healthcare costs, mainly due to decreased hospitalization expenses.
• A modest increase in outpatient primary care visits was observed in the intervention group.
• No adverse effects on patient satisfaction were noted.

Conclusions:

• A reflecting interview, combined with regular primary care visits, can effectively decrease healthcare utilization among high-utilizing patients with MUPS.
• This intervention offers a potential strategy for managing complex patient populations and reducing healthcare expenditures.
• Further research is warranted to explore the long-term effects and broader applicability of reflecting interviews.